Imperial College London
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Mr Oliver Boughton

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Research Fellow
 
 
 
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Contact

 

o.boughton

 
 
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Location

 

The MSk LabCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Boughton:2015:sicotj/2015011,
author = {Boughton, OR and Bernard, J and Szarko, M},
doi = {sicotj/2015011},
journal = {SICOT-J},
title = {Odontoid process fractures: the role of the ligaments in maintaining stability. A biomechanical, cadaveric study},
url = {http://dx.doi.org/10.1051/sicotj/2015011},
volume = {1},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Aims: We wished to investigate the role of the cervical ligaments in maintaining atlantoaxial stabilityafter fracture of the odontoid process.Methods: We dissected eight fresh-frozen cadaveric cervical spines to prepare the C1 and C2 vertebrae for biomechanicalanalysis. The C1 and C2 blocks were mounted and biomechanical analysis was performed to test the stabilityof the C1-C2 complex after cutting the odontoid process to create an Anderson and D’Alonzo type II fracture thensuccessive division of the atlantoaxial ligaments. Biomechanical analysis of stiffness, expressed as Young’s modulus,was performed under right rotation, left rotation and anterior displacement.Results: The mean Young’s modulus in anterior displacement decreased by 37% when the odontoid process was fractured( p = 0.038, 95% confidence interval 0.04–1.07). The mean Young’s modulus in anterior displacement decreasedproportionally (compared to the previous dissection) by the following percentages when the structures were divided:facet joint capsules (bilateral) 16%, ligamentum flavum 27%, anterior longitudinal ligament 10%. These differencesdid not reach statistical significance ( p > 0.05).Discussion: We have found that the odontoid process itself may account for up to 37% of the stiffness of the C1-C2complex and that soft tissue structures account for further resistance to movement. We suggest magnetic resonanceimaging (MRI) of the soft tissues in the acute setting of a minimally displaced odontoid process fracture to plan managementof the injury. If the MRI determines that there is associated ligament injury it is likely that the fracture isunstable and we would suggest operative management.
AU  - Boughton,OR
AU  - Bernard,J
AU  - Szarko,M
DO  - sicotj/2015011
PY  - 2015///
SN  - 2426-8887
TI  - Odontoid process fractures: the role of the ligaments in maintaining stability. A biomechanical, cadaveric study
T2  - SICOT-J
UR  - http://dx.doi.org/10.1051/sicotj/2015011
UR  - http://hdl.handle.net/10044/1/26911
VL  - 1
ER  -
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